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EpiphanyRx Member FAQs

Formulary and Drug Lists

EpiphanyRx Formulary

EpiphanyRx ACA Preventive Drug List

EpiphanyRx HSA Preventive Drug List

EpiphanyRx Maintenance Drug List

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Home Delivery Flyer

Costco Patient Profile Form

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Pharmacy Directory

EpiphanyRx Pharmacy Directory

Reimbursement Claim Forms

EpiphanyRx Member Reimbursement Form

EpiphanyRx Compound Claim Reimbursement Form

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Release of Information Form

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Prior Authorization Form

Exception to Coverage Request

Pharmacies

Pharmacy Network Credentialing Form

Pharmacy Manual

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